Revenue Cycle Management
- Posted: 15 June 2021
- Phoenix, AZ, USA
At American Vision Partners (AVP), we’re bringing the best together. Our company was created with the affiliation of Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, and the M&M Eye Institute. Today we’re one of the nation’s largest and most comprehensive ophthalmology practices with more than 45 eye care centers in Arizona, Nevada, California and New Mexico - including 24 ambulatory surgical centers. At AVP we are committed to best in class patient care, being a pioneer in research and technology and most importantly, rewarding and recognizing our employees!
Coding Training Manager
American Vision Partners- Phoenix Biltmore
This position aids in the training of properly coding claims to capture charges and correctly bill for services performed. Training and Revenue Integrity minimizes departmental rework, reprocessing of multiple claims from misaligned coding, and tracks and trends repeated missed opportunities for compliant charging and proactively finds and/or provides input regarding tools to streamline and/or improve charging processes. This position assists with maximizing revenue by identifying trends and remediate charge leakage or overage.
- Analyze daily financial exceptions from the charge capture audit reports to determine areas of leakage and partner with information technology and clinical service lines to rectify charge capture issues by assisting service lines to improve their ability to capture compliant charges.
- Perform root cause analysis, when warranted by continuous trends when warranted by continuous trends, to pinpoint areas process gaps and continue to monitor and remediate any trends of charge leakage or overcharges
- Ability to track and report the percentage of generated revenue and overall improvement related to any new initiative.
- Supports Management by providing information, locating data resources and collecting data under tight time constraints.
- Provide analysis to monitor correct coding by the coding staff, and monitor coding related denials to identify trends and maximize facility reimbursement.
- Perform root cause analysis on coding related denials and provide recommended process improvements to reduce denials.
- Resolve complex patient and physician issues as necessary.
- Collaborates with internal departments to understand other system interfaces to ensure appropriate coding. Interface with operational and clinical leadership to assist in identification of operational and clinical best practices in maximizing revenue, understanding clinical suspects and monitoring of appropriate clinical documentation and quality coding. Assist with the creation of EMR forms to make sure documentation requirements are met for all services.
- Assist physicians and other clinic staff with coding and billing-related questions. Provide resources to educate and assist providers with AVP processes.
- Develop and present coding presentations and training to large and small groups of clinicians, practice managers and coders – developing training to fit specific needs.
- Supports management by providing information, locating data sources and collecting data under tight time constraints.
- Research, review and approve all SIM code changes, updates and additions within the established timeframes.
- Research new drugs, technology or procedures including but not limited to reimbursement for billing, EHR and claim requirements.
- Review and test any coding related changes to EHR or Autoflow.
- Review and follow up on coding IT Tickets within the established timeframes.
- Onboarding of new providers.
- Review, update and maintain system edits to ensure timely claims submission.
- Prioritize work to maximize turnaround times.
- Performs all other assigned duties.
- HS diploma or GED required.
- Certified Professional Coder (CPC) required
- 5 years medical billing experience required
- Ophthalmology background a plus
- Requires 3 or more years in a leadership role
- Previous experience providing coding education training, with preferred training to providers.
- Knowledge of electronic health record systems for applying codes and/or checking codes for accurate assignment based on provider documentation.
- Analytical skills necessary to dissect complicated issues and formulate creative solutions for problem solving.
- Strong background and experience in revenue cycle reimbursement.
- Active knowledge of CMS guidelines contracted insurance guidelines and coding policies.
- Demonstrated computer literacy including Microsoft Office applications.
- Well-organized with attention to detail.
- Ability to read and understand oral and written instructions.
- Excellent math skills.
- Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients.
- Professional customer service skills.
- Have a desire and dedication to work with self-discipline.
- Maintains the strictest confidentiality: adheres to all HIPAA guidelines and regulations.
Benefits & Perks:
Your health, happiness and your future matters! At AVP, we offer everything from medical and dental to significant eye care discounts, continuing education, 401(k), 9 paid holidays plus PTO, flexible work hours and much more!
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.